Mumps

Mumps is an infectious illness caused by a virus. It is spread from an infected person by saliva or mucous droplets when coughing, sneezing, or talking. It can also be spread via face to face contact within a metre, or by touching an object infected from saliva and mucous, such as a used tissue or keyboard.

Usually, a few cases occur each year in New Zealand but during 2017 a mumps outbreak has affected over 800 people, mostly in Auckland. So far, most have been aged 10–29 years as this age group has lower than average vaccination rates.

Key points

  1. The symptoms of mumps are usually mild, such as swollen salivary glands (at the side of your face), headache and fever. It often gets better without needing medical help.
  2. Mumps can, however, cause serious complications such as deafness, swollen testicles or ovaries and meningitis.
  3. People with mumps need to stay home from work, school or day care for 5 days after the swelling starts so you don’t spread the virus to others.
  4. Because mumps is very contagious, you need to practise strict hygiene, such as washing your hands with soap and warm water, if you have mumps or are caring for someone with mumps.
  5. Vaccination with the measles, mumps and rubella (MMR) vaccine is the best way to protect against mumps. In New Zealand, it is part of the immunisation schedule for infants at 15 months of age and the second dose at 4 years of age. However, parents can request that the first MMR vaccine be given anytime after 12 months of age and the second dose any time from 4 weeks after the first.  

(Video from the Immunisation Advisory Centre, NZ)

What is mumps?

Mumps is caused by a virus called paramyxovirus, which is found in your saliva (spit) and secretions of your nose and throat.

  • Mumps is spread when a person breathes in the virus that has been coughed or sneezed into the air by an infectious person.
  • It can also be spread via face to face contact within a metre, or by touching an object infected from saliva and mucous, such as a used tissue or keyboard.
  • Although usually considered a disease of childhood, adults accounted for more than a third of the cases in New Zealand in 2008.

How contagious is mumps?

Mumps is easily passed from person to person. A person can transmit the virus to others up to 5 days before they know they have mumps until 9 days after they first have symptoms. If you have mumps, you need to stay home from work, school or day care so you don’t pass it on to anyone else.

Who is at risk of getting mumps?

Anyone can get mumps, but you are at greater risk of getting mumps if you come into contact with an infectious person and have never had mumps or haven’t been immunised against it. For example, 

  • Children under 15 months of age.
  • People with a weakened immune system (immune-compromised) can become seriously ill and develop severe complications. These people include:
    • transplant patients
    • those with illnesses such as leukaemia or HIV
    • cancer patients receiving chemotherapy or radiotherapy
    • people taking high-dose steroid or immune suppressive medication. 
  • People born in New Zealand after 1981 who have not had mumps infection or do not have two documented measles-mumps-rubella (MMR) immunisations have the highest risk of catching mumps.
  • People born in Fiji, Tonga, Kiribati, Nauru, Papua New Guinea, Solomon Islands, Tuvalu and Vanuatu, as well as many mainland nations in Asia, may not have been offered mumps immunisation as children.

Mumps and pregnancy

Pregnant women who become ill with mumps are at a risk of miscarriage in the first 3 months. 

  • Pregnant women who have received 2 doses of the MMR vaccine in the past, before their pregnancy, are almost certainly protected.
  • Pregnant women should not be given the MMR vaccine. If you are pregnant and think you have come in close contact with someone with mumps, call your GP or lead maternity carer as soon as possible.

What are the symptoms of mumps? 

The most common symptom of mumps is painful swelling in one or both salivary glands just under your ears and behind your jaw. The swelling usually develops over 2 or 3 days, before reaching a peak and easing off. It tends to last around 8 days. The glands are sensitive to touch but not usually red and hot. undefined

Other symptoms include:

  • fever
  • pain when chewing and swallowing
  • sore throat
  • tiredness
  • loss of appetite
  • mild abdominal (tummy) pain
  • dry mouth
  • headache.

Men and adolescent boys can experience pain and swelling in their testicles. Some people, mainly young children and older adults, may not have any symptoms even though they have the disease. The time from being exposed to the virus and becoming sick is usually about 2 to 3 weeks.

Can there be complications from having mumps?

In most cases, mumps does not cause serious damage to a person's health, but in rare cases it can cause serious complications, such as:

  • hearing loss – in most cases this is temporary and will pass, but, in some cases, it can be permanent
  • swollen testicles or scrotum (orchitis) – this affects 1 in 5 adult males with mumps and in rare cases cause infertility (inability to have children).
  • swollen ovaries (which causes a more severe tummy pain) and swollen breasts in girls and women
  • inflammation of your brain (called encephalitis)
  • inflammation of the lining of your brain and spinal cord (called meningitis)
  • increased risk of miscarriage in the first trimester of pregnancy.

How is mumps diagnosed?

In most cases, a doctor will diagnose mumps based on the symptoms, particularly the swollen salivary glands and fever.

If your symptoms are severe, or there are complications, you may be asked to have blood or urine test, or a cerebrospinal fluid test (lumbar puncture or spinal tap). Your doctor may also ask you about any recent travel overseas. The risk of mumps is higher in some countries that do not have immunisation against mumps as part of their immunisation schedule.

How is mumps treated?

There is no specific medical treatment for mumps. Antibiotics don't work because the illness is viral. Treatment aims to ease your symptoms and reduce the risk of complications.

What self-care can I do if I have mumps?

  • Have plenty of bed rest.
  • Place a warm flannel or wheat bag, or a cold pack, against your swollen glands to ease tenderness.
  • Drink plenty of cool fluids, especially water.
  • Avoid acidic drinks, such as fruit juices, as they can stimulate your salivary glands and cause you more discomfort.
  • Eat soft foods that don’t require much chewing, such as porridge or soup.

Medications

  • Paracetamol can be given to help reduce your fever and ease any pain. Make sure you measure children's doses accurately and follow the directions given on the bottle or product packaging.
  • Men with severe inflammation in the testicles may be prescribed a stronger pain reliever or corticosteroid to reduce inflammation.

How can I prevent the spread of mumps?

Mumps is spread when a person breathes in the virus that has been coughed or sneezed into the air by an infectious person. It can also be spread by direct contact with infected saliva, such as through touching a contaminated tissue or computer keyboard.

If you have mumps

To stop spreading the virus to others, people with mumps need to stay home from work, school or day care for 5 days after the swelling starts. Because mumps is very contagious, you need to practise strict hygiene, such as washing your hands with soap and warm water, if you have mumps or are caring for someone with mumps. Cover your coughs and sneezes — use tissues and throw used tissues in the rubbish bin. 

If you come into contact with someone who has mumps

If you come into contact with someone who has mumps, and you have never had mumps or haven’t been fully immunised against it, you are required to be in quarantine at home. The quarantine period starts 12 days after your first contact with an infected person, lasting until 25 days after your last contact. This means you cannot attend early childhood centres, school, work, sporting events, social activities or shopping malls or use public transport for that time. 

Vaccination

Vaccination is the best way to prevent mumps.  No mumps-only vaccine is available in New Zealand. The combination measles, mumps and rubella (MMR) vaccine protects against mumps. Two doses of MMR vaccine are recommended after the age of 12 months, given at least 4 weeks apart. Having only one dose of the MMR vaccine is not adequate protection against mumps.   
  • After the first dose of MMR vaccine, between 69 to 81 people out of 100 will be protected from mumps, but after two doses, up to 90 people out of 100 will be protected.
  • Check with your GP or practice nurse to see if your child has received both vaccinations. If they haven’t, get them vaccinated as soon as possible. Vaccination is free.
  • If your child was born outside of New Zealand or you are not sure whether you or your child has had two doses of MMR, it’s safer to get vaccinated as there’s no additional risk to having a third dose.
  • A small number of people who have been vaccinated will still catch mumps, but they are less likely to be seriously ill.

Learn more

The following links provide more information on mumps.

Mumps Ministry of Health, New Zealand, 2017
Mumps factsheet Auckland Regional Public Health Service
Mumps - information for people at high risk Auckland Regional Public Health Service
Mumps The Immunisation Advisory Centre, New Zealand

References

  1. Mumps Immunisation Handbook 2017, New Zealand
  2. Managing the mumps outbreak Auckland Regional Public Health Service 
Credits: Editorial team Health Navigator. (Photo courtesy of the Centers for Disease Control, USA). Last reviewed: 02 Oct 2017